Professional Billing Quality Coding Auditor, FT, Days, - Remote

About the Role

Performs routine and specialty reviews of coders to ensure accurate coding. Prepares a summary of findings and presents reports to leadership on a monthly basis. Assists with training coders on identified opportunities for improvement and in preventing coding denials.

Responsibilities

• Performs multi-specialty reviews for the Medical Group validating the CPT, ICD-10, modifiers, and HCPCS codes using official coding guidelines and CMS guidelines; prepares a summary of findings.
• Performs review of all coders within the department and prepares a summary of findings.
• Provides training to coders on identified issues found during reviews.
• Codes charges for professional billing based on review of clinical documentation.
• Identifies and assists with the resolution of coding issues and process improvement.
• Assists in creating edits to prevent denials.
• Assists in creating a standardized process for front-end coding, including the development of training materials.
• Mentors and trains coders on correct coding guidelines.
• Interacts with other departments to assist in resolving coding issues.
• Performs other duties as assigned.

Requirements

• Bachelor's degree in Business or related field of study.
• Three (3) years of multi-specialty coding experience in professional billing.
• CPC (Certified Professional Coder) and CPMA (Certified Professional Medical Auditor) certifications from AAPC.

Skills

• Knowledge of medical terminology and basic anatomy and physiology with the ability to apply coding concepts to ensure correct coding.
• Analytical skills.
• Working knowledge of Epic, Encoder Pro, and 3M.
• Ability to work independently and manage multiple projects consistently.
• Proficient computer skills (word processing, spreadsheets, database).
• Data entry skills.

Schedule

Day shift.